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Atrial fibrillation (AF) occurs 15 times more commonly in patients with cirrhosis than in the general population. However, patients with cirrhosis have been excluded from randomized clinical trials in which anticoagulants were assessed in patients with AF. Investigators used two large U.S. insurance databases of nearly 25,000 patients with cirrhosis and new-onset nonvalvular AF to perform a propensity score–matched comparison of patients who initiated apixaban and patients who initiated either rivaroxaban or warfarin.
Patients who received apixaban were significantly less likely to have major bleeding than patients who received rivaroxaban (5.1% vs. 8.7% annually) or warfarin (5.1% vs. 7.9% annually). No differences in ischemic embolic event…